Neurofibromatosis type 1 associated with moyamoya syndrome in children

Pediatr Neurol. 2014 Jan;50(1):96-8. doi: 10.1016/j.pediatrneurol.2013.04.007. Epub 2013 Oct 23.

Abstract

Background: Vascular abnormalities in neurofibromatosis type 1 may arise anywhere in the cardiovascular system, and cerebrovascular involvement is the predominant feature of moyamoya syndrome. Because neurofibromatosis type 1 is a neurocutaneous disorder and routine follow-up with cranial MRI is not standard practice in asymptomatic children, accurate epidemiologic data are lacking. On follow-up, clinical and radiologic progression is often found in patients with moyamoya syndrome.

Methods: We performed a retrospective analysis on children with neurofibromatosis type 1 who had been diagnosed with moyamoya syndrome on cranial MRI.

Results: Of the 197 children diagnosed with neurofibromatosis type 1, 168 had undergone a cranial MRI, and four (2.3%) of them had moyamoya syndrome. At diagnosis, one child had headache and vomiting related to a right frontal hematoma and the other three children were asymptomatic, including one child with a previous history of renal arteriopathy. In two children moyamoya syndrome was unilateral.

Conclusions: The association between moyamoya syndrome and neurofibromatosis type 1 is rare, but it poses a potential risk of clinicoradiologic progression. Targeted monitoring of children with neurofibromatosis type 1 ensures an early diagnosis of moyamoya syndrome.

Keywords: cerebrovascular; childhood; moyamoya; neurofibromatosis type 1.

MeSH terms

  • Adolescent
  • Brain / diagnostic imaging*
  • Brain / pathology*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Magnetic Resonance Angiography
  • Magnetic Resonance Imaging
  • Male
  • Moyamoya Disease / complications*
  • Moyamoya Disease / diagnosis
  • Neurofibromatosis 1 / complications*
  • Neurofibromatosis 1 / diagnosis
  • Radiography